Psychotropic medication utilization at a group-home residential facility for children and adolescents.
OBJECTIVE
The purpose of this study was to examine psychotropic medication utilization over the course of treatment for children and adolescents admitted to a large residential group-home facility for youth with emotional and behavioral disorders.


METHODS
Retrospective analyses of psychotropic medication utilization at admission, during treatment, and at departure were examined for 1,010 children and adolescents consecutively admitted to the facility during 2001-2004. The relationship between psychotropic medication utilization and demographic variables, psychiatric diagnoses, objective measures of behavioral and emotional problems, in-program behavior, and ratings of program success were examined.


RESULTS
The overall utilization rate was 49%, and there was a significant reduction in utilization from admission (40%) to departure (26%). Reductions were evident across all medication classes (e.g., stimulants, antipsychotics, etc.). At admission, medication utilization was related to several psychosocial variables, higher scores on measures of behavioral and emotional problems, and psychiatric diagnoses (attention-deficit/hyperactivity disorder (ADHD) and mood disorders). A small percentage (16%) of youth was prescribed novel medication during stay. Being placed on medication during treatment was related to internalizing problems on the Child Behavior Checklist (CBCL) at admission, psychiatric diagnoses, higher rates of in-program behavior problems, and poorer outcomes at departure. Youth departing on medication were more likely to be male, younger, and rated as doing more poorly in the program. They also were more likely to be placed in more restrictive settings at follow-up.


CONCLUSIONS
There was a high rate of psychotropic medication utilization among this population, though utilization rates dropped significantly over the course of treatment.
Handwerk
Michael L
ML
Harrisburg Medical Center, Behavioral Health, Harrisburg, Illinois, USA. mhandwerk@harrisburgmedicalcenter.org
Smith
Gail L
GL
Thompson
Ronald W
RW
Spellman
Douglas F
DF
Daly
Daniel L
DL
D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D002648:Child; D002653:Child Behavior Disorders / Q000188:drug therapy*; D005260:Female; D016352:Group Homes / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D019964:Mood Disorders / Q000188:drug therapy; D010818:Practice Patterns, Physicians'; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012114:Residential Treatment / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
D011619:Psychotropic Drugs